Factors influencing the choice of graft type in ACL reconstruction: Allograft vs autograft

BACKGROUND Anterior cruciate ligament (ACL) reconstruction is the prevailing procedure in cases of ACL rupture. OBJECTIVES To analyze ACL reconstruction based on time and costs of the surgery, postoperative pain, postoperative complications, time it takes to return to work or other such physical activity, and cosmetic effects. MATERIAL AND METHODS The retrospective analysis involved 62 patients who had undergone ACL reconstruction with the same results in clinical and functional assessment, which were then divided into 2 groups. In one group, an allograft was utilized, while in the other group - an autograft. The time it takes to perform the surgery, the cost, pain expected to be experienced, the possibility of postoperative complications, scarring, and the time needed for return to work were all considered and analyzed. RESULTS The surgery time was 40.64 ±4.23 min in group I in comparison to 52.48 ±4.92 min in group II (p < 0.05). The cost of surgery was 32% higher in group I. Visual analogue scale (VAS) pain score in group I was from 36.45 ±8.39 mm on the 3rd day to 15.16 ±5.70 mm on the 28th day. In group II, it ranged from 60.67 ±10.15 mm on the 3rd day (p < 0.05) to 18.67 ±6.81 mm on the 28th day. The time of return to office work in group I was 6.96 ±1.9 weeks and 9.27±1.57 weeks in group II (p < 0.05). The time of return to physical work in group I was 19.85 ±2.79 weeks, and 20 ±3 weeks in group II. Postoperative scar and local complications were statistically less pronounced in group I. CONCLUSIONS Allografts achieve less postoperative pain, smaller local complications, shorter time necessary to return to work, and better cosmetic effect. However, an allograft is more expensive to perform.